Ted Simons:
What was once commonly referred to as senility or dementia is now known as Alzheimer's disease. It is a brain disorder characterized by cognitive and memory loss. But is it normal aging, or is it possible to prevent Alzheimer's disease? Are there avoidable risk factors and measures that can be taken to stop or slow the process? Dr. Marwan Sabbagh is a neurologist and leading expert in Alzheimer's research. He has authored a book called the "Alzheimer's Answer." joining me now is Dr. Sabbagh. And doctor, thank you for joining us on Horizon.

Marwan Sabbagh:
Thank you for having me.

Ted Simons:
Is there an answer for Alzheimer's disease?

Marwan Sabbagh:
A very complex topic and question. What we do know there are risks that we consider modifiable and the book says we can take it upon ourselves to reduce the risk. The is essentially what the answer would be, we do not want to wait for our unforgetfulness.

Ted Simons:
Let's start with basics. Can Alzheimer's be prevented?

Marwan Sabbagh:
That's the premise of the book. We know that you could make an argument that Alzheimer's is an inevitability. We know there's risks we can change. We might be able to delay it if not prevent it. They say you could reduce it by 75\% if you follow all recommendations. I can answer yes, time will tell.

Ted Simons:
Same question about Alzheimer's being slowed when it comes on?

Marwan Sabbagh:
Correct. Correct. The things we can't change are age and heredity. But clearly there might be other things that we can reduce.

Ted Simons:
Let's talk about the key factors. Obviously heredity has to play a very big part, age and what other factors?

Marwan Sabbagh:
Those are the two unmodifiable risk factors. But modifiable risk factors would include health factors like cholesterol, heart disease, diabetes, body weight. We know there's an association with obesity and Alzheimer's disease. Dietary changes. And other health habits as well.

Ted Simons:
Do any of those factors weigh more than the others?

Marwan Sabbagh: That's not clear. We know if you look at each of these individual opponents, they address for risk reduction. I don't think anybody, scientifically speaking if you control your diabetes more than blood pressure, you reduce the risk of Alzheimer's. I don't think we've extrapolated that far.

Ted Simons: How about a vaccine for Alzheimer's? I know there has been a lot of talk about this. Any progress at all?

Marwan Sabbagh:
Huge amount of progress. Chapter 20 of book I talk about Alzheimer's disease in the way it's not talked about. I talk about it as from a terminal disease to a chronic disease much like diabetes is. That evolution is happening now. There's over 60 drugs in development for the treatment of Alzheimer's among them are vaccines. Half a dozen companies are working on vaccine therapy now.

Ted Simons:
That's going back to the idea of slowing Alzheimer's once diagnosed?

Marwan Sabbagh:
Correct.

Ted Simons:
Do you see a time when diagnosed with Alzheimer's suffer some of the symptoms and live a long and otherwise healthy life?

Marwan Sabbagh:
Yes, that's the vision I see in the future. Harkin back to quarter of century with H.I.V. you had H.I.V. you were going to die. It was inevitability. Now you can slow it down and people live long periods of time. Same thing will happen with Alzheimer's. You will be identified early in the disease. We'll give you a cocktail what I consider to be chemo therapy type approach where you take five or six medications not just one and that will arrest your progression and live a productive life.

Ted Simons:
The concept of exercising your brain has been talked about a lot even for the folks not on the road to Alzheimer's, if you will, it's a good idea it's a muscle, use it or lose it type of things. Are there certain brain exercising that are better than others?

Marwan Sabbagh:
Once you have Alzheimer's disease, it has shown to reduce the risks of complications like behavioral changes. One of those things you want to understand like mentally stimulating is probably better for prevention than for treatment.

Ted Simons:
So, do a soduko puzzle, do a crossword puzzle, learn a new language.

Marwan Sabbagh:
No, it cannot. My dad is 75 and learning a new language. One of things we know is engaging in stimulating activities does reduce the risk for developing Alzheimer's. We have used it to think it was strictly western society but they studied it in China and found those who played a Chinese game did better than those who didn't. We know crossword puzzles and do we know that one is better than the other, we don't know the answer. It's helpful and added to animal models. When looking at animal studies those less stimulated had more Alzheimer's in the brain.

Ted Simons:
Food and drink. How much does it factor into this?

Marwan Sabbagh:
A lot. Our dietary can influence it. We know diets high in saturated fats increase risks for Alzheimer's. There's been some studies which suggest that the Mediterranean diet, fish, whole grains, and a little bit of red wine does reduce the risk of developing Alzheimer's disease. We know that certain types of fish, not all fish are going to be good. If you have to eat one fruit, I would say it's blueberries for sure not muffins but berries.

Ted Simons:
Supplements?

Marwan Sabbagh:
Supplements are a little controversial. I spend a chapter on the supplements. Folic acid as the best evidence of protection. There's some controversy and evidence with vitamin e. If I had to bet, I would bet on folic acid for risk reduction. Two studies have been very good evidence for that. In terms of supplements you can take a whole cornucopia of memory improving. If I have to pick the supplements it would be huperzine, turmeric, resverotrol, curcumin, phosophotulseurum, and others.

Ted Simons:
I know turmeric is in the food.

Marwan Sabbagh:
India has the lowest Alzheimer's in the world. India is a genetically diverse country. It has one of the most potent free radicals scavengers, antioxidents, and anti inflammatories. It's a natural food preservative.

Ted Simons:
We keep hearing about especially red wine helping a variety of things. Does it play a factor here?

Marwan Sabbagh:
Very cautious about alcohol, two, four ounces glasses of wine, or two shots of spirits not and or less, might reduce the risk. Any alcohol consumption anything above the amount of 230 grams ethanol you increase the risk for developing Alzheimer's disease. What's not clear is it any alcohol consumption or red wine? It has the way to show to preserve the longevity of brain cells.

Ted Simons:
Are you optimistic?

Marwan Sabbagh:
I am optimistic. My goal as I tell people in life is to work myself out of a job. For right now I have job security in foreseeable future. The way we see Alzheimer's will change. Like said we will change it to chronic disease and identify people at-risk through a blood test or scan you're at-risk 10\% or 80\%. I believe prevention is a major step forward in the future.